Tremor

Atypical Pakinsonism

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Atypical Pakinsonism, Atypical Parkinson's Disease, Atypical Parkinson Disease

  • See Also
  1. Parkinson's Disease
  • Course
  1. Rapidly progressive or early Dementia
  2. Rapidly progressive course
  • Signs
  • Prominent features
  1. Upper Motor Neuron signs
    1. Axial rigidity is greater than extremity rigidity
  2. Cerebellar signs (dysmetria, Ataxia) with impaired gait
  3. Impaired speech
  4. Urinary Incontinence
  5. Early symptomatic Postural Hypotension
  6. Distinguishing features
    1. Resting Tremor absent
    2. Refractory to Carbidopa/Levodopa
  • Signs
  • Progressive Supranuclear palsy (Supranuclear Gaze Palsy)
  1. Olfaction is normal
  2. Vertical Gaze Paralysis and postural instability
    1. Difficulty reading
    2. Loss of Down gaze
  • References
  1. Ahlskog (2011) Mayo Internal Medicine Review Lecture
  2. Schim (2001) CMEA Medicine Lecture, San Diego
  3. Clarke (2003) Clin Evid 10:1582-98 [PubMed]
  4. Clarke (2004) Lancet Neurol 3:466-74 [PubMed]
  5. Gazewood (2013) Am Fam Physician 87(4): 267-73 [PubMed]
  6. Nutt (2005) N Engl J Med 353:1021-7 [PubMed]
  7. Olanow (2001) Neurology 56:S1-88 [PubMed]
  8. Rao (2006) Am Fam Physician 74:2046-56 [PubMed]
  9. Young (1999) Am Fam Physician 59(8):2155-67 [PubMed]